NPI | 1053372409 |
---|---|
Former Name | LINDA LEE PANNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 5495) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 1887) |
Enumeration Date | 2006-03-28 |
Last Update Date | 2014-02-13 |